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By Beth Orenstein

Beth Orenstein is a freelance writer from Northampton, Pa. A graduate of Tufts University, she covers health and insurance topics.

What is most important to consumers when choosing a health insurance plan?

Low cost.

At least, that's according to an online survey by HealthPocket.com, a website that compares and ranks health insurance plans available to individuals, families and small businesses.

Survey results

The online survey asked 900 adults across the country: If health insurance plans in your area all offered the same benefits, what factor would be most important in determining your choice?

The survey found:

32 percent said a low monthly premium.

22 percent said a plan that accepts their doctors.

17 percent said their out-of-pocket costs.

19 percent said a brand they know and trust.

Only 10 percent said customer satisfaction with the care they received and the quality ratings of the health-care providers in the plan were most important.

"We've always known that consumer choice of health insurance is driven more by cost than by quality," said Bruce Telkamp, CEO of HealthPocket in a press release on the survey.

Effects of Affordable Care Act

However, HealthPocket said, consumers' reasons for choosing health plans are likely to change some next year when more provisions of the Affordable Care Act take effect.

Health care reform should transform health insurance shopping by standardizing the basic benefits that must be offered to consumers and make it easier for consumers to switch plans.

Under the new law, health plans will fall into four categories (bronze, silver, gold and platinum) based on the percentage of expected health-care costs the policyholder will have to pay out-of-pocket. Also, all health plans will be required to provide coverage for essential health benefits. In addition, health plans will no longer be able to reject applicants because of preexisting conditions or increase premiums because of high usage.

HealthPocket said the changes will make it easier for consumers who are dissatisfied with their plan to switch, making the providers more competitive.

More emphasis on quality coming

Also, Health Pocket said, consumers will have more access to information about how their plan works. As a result, high quality plans should dominate in their markets over time.

That only one out of five respondents said brand loyalty was important in making their selection could be troubling news for health insurers. It suggests that consumers may be willing to make side-by-side comparisons when under the Affordable Care Act it will be simple to do. When they make comparisons, consumers will go with the plan that has the benefits they want most, not with the company they've always known.

However, health insurance reviews aren't expected to play a role in choosing plans. They don't now and won't in the future, HealthPocket said. An earlier survey by the Health Research Institute found that only 16 percent of those surveyed had read, used or written a review on a health insurance company.